In the first quarter of 2021, Advisory Board surveyed a sample of 225 providers in various value-based payment (VBP) arrangements from across the country. The survey asked about their readiness for risk and their most effective support resources. We found that plans are still operating on outdated strategies that were formed when value-based payment was in its infancy. We’ve highlighted three lessons providers in downside risk learned on their path to value-based payment that all health care leaders should consider as they attempt to get providers into downside risk arrangements.